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Ophthalmologists must be determined to turn global crisis into a positive opportunity
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 Matteo Piovella |
The current economic and financial downturn is having deep repercussions on industry investment policies and social welfare budgets. How deeply the crisis will affect Europe, structurally and psychologically, is still unclear. Caught in between discrepant interpretations and common misperceptions, many are convinced that the public — the potential customers — will be oriented more toward spending. In many cases, not because they do not have the money, but because they are concerned about their future.
European national health systems will undoubtedly continue to guarantee basic services such as cataract surgery, and there will be no cutbacks on the number of interventions within NHS institutions. Private practices, on the other hand, are likely to suffer if they fail to use the economic downturn as an opportunity to become more competitive, improving services and investing in the best and most updated techniques and technologies.
In particular, I refer to the use of premium IOLs — multifocal, toric and accommodative. They make a substantial difference in the way you deal with your patients. They require a better and more accurate assessment, longer chair time and clear, detailed information to the patients, who are directly involved in decision-making. With premium IOLs, you are offering not just a standard lens, but a series of options to match personal needs and demands. By becoming mutually involved in treatment planning, you give more value to your role and to the patient and, consequently, add more value to your practice.
Now that the time of routine, assembly-line style cataract surgery is over, we should also expect, and work together to obtain, a more substantial reimbursement for this procedure within the NHS system. The old €800 to €900 all-included is an obsolete price for an obsolete concept of cataract surgery. An increase of at least 50% should be granted to allow all eligible patients to be implanted with premium lenses. The eyesight and happiness of our patients is worth the extra cost.
As health care professionals, we should plead the case for the protection of health, and never let it fall in the hands of politicians and economists. We should also reflect on our own behaviors and learn from our mistakes. Proposing techniques such as cataract surgery without the use of viscoelastics because it saves money or publicly declaring that bilateral cataract surgery is better and cheaper with “only a minimal risk of adverse events that might lead to loss of vision” is ethically unacceptable. We should not be accomplices to those who want to save on health or turn health care into mere business. Let’s leave this to the economists and politicians who are trying to push us in this direction. Let them tell our patients that they are not important enough to deserve the extra costs of better vision and a better quality of life because they are too old or too low on the social scale to be considered appropriate candidates for the new technologies.
In these days of global recession, the pressure from economists is getting stronger, but we should reject it forcefully. As medical doctors, we are obliged by the Hippocratic Oath to give our best support to all patients, regardless of their income, education or social status. All our patients deserve the best, and they put their faith and trust in us, not the economists.
The economic downturn is forcing us to learn how to eliminate waste and optimize time and resources. Yet, the decreasing demand requires a proactive approach. Giving ourselves a better organization, fine-tuning our practices, offering diversified and better services, and transitioning to newer technologies will help us fight the crisis with positive results.
In all our surgical subspecialties, technology has made giant steps. The opportunities for our patients have immensely increased and remain cost-effective. Our economies can still afford the price of high-quality services and products to protect the right to health of their citizens.
We have the responsibility to uphold the standard of practice as well as the ethical standards of our profession. Only in this way, when the global crisis comes to an end, will we be able to fully and proudly enjoy the fruits of our labor: having maintained the extraordinary high standards of today’s ophthalmology.